In this randomized controlled trial, eligible patients in our hospital were enrolled and allocated randomly to the experimental group (expanded periurethral cleansing protocol; n = 225) or the control group (usual periurethral cleansing protocol; n = 221). The incidence of CAUTI on days 3, 7, and 10 after catheter insertion were compared, and the pathogen results and influencing factors were analyzed.
The incidences of CAUTI in the experimental and control groups on days 3, 7, and 10 were (5/225, 2.22% vs. 7/221, 3.17%, P = 0.54), (12/225, 5.33% vs. 18/221, 8.14%, P = 0.24), and (23/225, 10.22% vs. 47/221, 21.27%, P = 0.001), respectively; Escherichia coli and Candida albicans were the most common species in the two groups. The incidences of bacterial CAUTI and fungal CAUTI in the two groups were 11/225, 4.89% vs. 24/221, 10.86%, P = 0.02) and (10/225, 4.44% vs. 14/221, 6.33%, P = 0.38), respectively. The incidences of polymicrobial CAUTI in the two groups were 2/225 (0.89%) and 9/221 (4.07%), respectively (P = 0.03). The percentages of CAUTI-positive females in the two groups were 9.85% (13/132) and 29.52% (31/105), respectively (P < 0.05). The proportion of CAUTI-positive patients with diabetes in the experimental and control groups was 17.72% (14/79), which was lower than the 40.85% (29/71) in the control group (P < 0.05).
Expanded periurethral cleansing could reduce the incidence of CAUTI, especially those caused by bacteria and multiple pathogens, in comatose patients with short-term catheterization (≤ 10 days). Female patients and patients with diabetes benefit more from the expanded periurethral cleansing protocol for reducing CAUTI.
在这项随机对照试验中,纳入我院符合条件的患者,随机分为实验组(尿道扩张清洗方案;n=225)和对照组(常规尿道清洗方案;n=221).比较导管插入后第3、7和10天的CAUTI发生率,并对病原菌检测结果及影响因素进行分析。
实验组和对照组在第3、7和10天的CAUTI发生率为(5/225,2.22%vs.7/221,3.17%,P=0.54),(12/225,5.33%与18/221,8.14%,P=0.24),和(23/225,10.22%与47/221,21.27%,P=0.001),大肠杆菌和白色念珠菌分别是两组中最常见的物种。两组细菌CAUTI和真菌CAUTI的发生率分别为11/225,4.89%。24/221,10.86%,P=0.02)和(10/225,4.44%vs.14/221,6.33%,P=0.38),分别。两组微生物CAUTI的发生率分别为2/225(0.89%)和9/221(4.07%),分别(P=0.03)。两组中CAUTI阳性的女性比例分别为9.85%(13/132)和29.52%(31/105),分别为(P<0.05)。实验组和对照组中CAUTI阳性的糖尿病患者比例为17.72%(14/79),低于对照组的40.85%(29/71)(P<0.05)。
扩大尿道周围清洁可以减少CAUTI的发生率,尤其是由细菌和多种病原体引起的,短期导管插入(≤10天)的昏迷患者。女性患者和糖尿病患者从减少CAUTI的扩大尿道周围清洁方案中受益更多。